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Author Topic: I want to drop Norivir from my Truvada combo  (Read 4374 times)

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Offline blowncircuit

  • Member
  • Posts: 6
I want to drop Norivir from my Truvada combo
« on: September 20, 2009, 11:02:25 PM »
I have been on the standard Truvada/Reyataz/Norivir combo for about a year and a half and my viral load has been undetectable for about a year and my T cells are over 600. In short it seems to be working well for me. However the one major side effect I have had with these drugs has been the damn bloating and gas. At times it can be downright ridiculous. I swear I wake up with a six pack and go to bed with a belly. The other big hassle is the whole refridgeration issue with Norivir as I travel alot.

A friend of mine is on the same combo sans the Norivir and he does not have as many bloat/gas issues. He also is undetectable with over 900 t cells. He takes twice the amount of Reyataz to make up for the Norivir.

I am in the process of changing doctors due to insurance changes and would like some feedback from anyone that has any input about this, prior to my first visit with the new doc.

Thanks in advance for any input! ;)

Offline sdguyloveslife

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  • Posts: 134
Re: I want to drop Norivir from my Truvada combo
« Reply #1 on: September 21, 2009, 02:53:56 AM »
I'm on a Norvir boosted combo as well, but I take Prezista (instead of Reyataz). 

Hmm, I may be mistaken, but from my understanding, it's the Truvada (specifically the tenofovir component) that gives you the gas and not the Norvir. 

Also, the refrigeration of Norvir is not absolutely necessary.  If the bottle gets too warm, the gelatin capsules will actually melt and stick together.  If this happens at normal room temperature, you can just tap the bottle against a hard surface and the capsules will separate quite easily.  If you look on the side of the Norvir bottle you will see the following statement: 

Refrigeration by patient is recommended but not required if used within 30 days and stored below 77 F (25 C).

So, even if you're traveling, your Norvir will be fine in your carry on luggage, or in your medication case. 

I haven't had much of a gas or bloating problem with this combo, but I imagine that an anti-gas supplement into your diet might help?  Perhaps some others will help here...
« Last Edit: September 21, 2009, 01:28:44 PM by sdguyloveslife »
Do not condemn the judgment of another because it differs from your own. You may both be wrong.

Offline markaj

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Re: I want to drop Norivir from my Truvada combo
« Reply #2 on: September 21, 2009, 03:35:55 AM »
I personally wouldn't be keen on taking 300mg Reyataz and Truvada without Norvir as a booster, although I'm aware of some patients taking 400mg (2 x 200mg capsules) of Reyataz without the Norvir, I don't know about taking twice the dose of Reyataz?

In your situation, it you're really not happy with the Norvir, I'd most probably talk to my doctor about ditching the Norvir and Truvada and take Epzicom and Reyataz instead.

I too experience gas which I attribute to Truvada, especially if I take it on an empty stomach.  I never had a problem with Norvir to be honest, although I didn't take it for long.


« Last Edit: September 21, 2009, 03:46:56 AM by markaj »
Infected Jan 08 / diagnosed Feb 08
Feb 08 - CD4 230 (9%) VL 3.5 million
Mar 08 - CD4 440 (6%) VL 660.000
Apr 08 - CD4 420 (11%) VL 3 million
Jun 08 - CD4 200 (7%) VL 3 million
Started Kaletra/Truvada Jul 08
Jul 08  - CD4 250 (14%) VL 23.893
Aug 08 - CD4 410 (15%)  VL 4.313
Switched to Sustiva/Truvada Aug 08
Switched to Reyataz/Norvir/Truvada Sep 08
Diagnosed with Hep C, HIV meds stopped for a bit
Nov 08 - CD4 414 (12%) VL 500.000+
Started Isentress/Truvada Nov 2008
Dec 08 - CD4 381 (17%) VL 1.116
Jan 09 - CD4 534 (20%) VL <50
Started Interferon/Ribavirin Jan 09
Feb 09 - CD4 407 (24%) VL <50
Mar 09 - CD4 360 (28%) VL <50
Apr 09 - CD4 279 (30%) VL <50
Jun 09 - CD4 298 (36%) VL <50
Aug 09 - CD4 303 (35%) VL <50

Offline mecch

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  • Posts: 11,482
  • red pill? or blue pill?
Re: I want to drop Norivir from my Truvada combo
« Reply #3 on: September 21, 2009, 05:05:39 AM »
Are these all home grown solutions?  Does your friend have any medical advice about his double dose of Reyataz?
WHy dont you ask your doctors to figure out a way to reduce the gas.  It might be a antigas pills. There are perscription ones and also natural enzymes.
Change of diet maybe.
Or maybe change of HAART.
But don't go messing with the therapeutic doses.

Also yeah Norvir can go without refrigeration and also I've heard it will have a new formulation soon.
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline Miss Philicia

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  • celebrity poster, faker & poser
Re: I want to drop Norivir from my Truvada combo
« Reply #4 on: September 21, 2009, 11:22:18 AM »
I agree with what markaj and sdguy stated -- the gas and bloating is most likely from truvada.  And I also agree with what sdguy stated about the Norvir/travel/fridge issue.  If you read the med label you'll see that one only refrigerates Norvir if you have in excess of a 30-day supply and the room temperature is abnormally hot.  The only issue with travel is that this should preclude placing your medication in your checked luggage, but then when one travels one shouldn't do this with any of your medication as it can get lost easily by the airline.

I'd also caution against listening to the anecdotes of one friend who has HIV.  I have a friend like this who likes to tell me all sorts of personal medical theories of what I should and shouldn't do (or at least he used to until I told him his beauty school certification was not as good as a doctor's medical degree).  He may be doing fine (in his mind and in yours) with his creative med protocol, but take 100 other patients in a controlled study that did this and you'll find that this would not be the case.  Now, of course you're welcome to do whatever you like with your own body and nobody can stop you, but I'd just ask you to consider that little fact when making up your mind.

That said, gas/bloating is totally uncomfy, and I've had this issue a lot.  I would recommend that you look into what I take for this, and while it does mean more pills each day and another prescription, I've found it totally works.

http://www.DigestiveCare.com/Information/?t=prod

I take Pancrecarb MS-8 twice daily and it effective controls the issue for me, and I've now taken it for four years.
"Iíve slept with enough men to know that Iím not gay"

Offline BM

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  • Posts: 340
Re: I want to drop Norivir from my Truvada combo
« Reply #5 on: September 21, 2009, 01:09:27 PM »
The standard dose of Reyataz without Norvir is 400mg once a day with food. If you're wanting to drop the Norvir, discuss it with your doctor: it is not recommended to take unboosted Reyataz if you've taken previous PI-based drug combinations. A formulation of Norvir that doesn't require refrigeration is expected soon; also, another company is looking into producing a booster that has none of the gastro-intestinal problems of Norvir (and none of the anti-HIV activity either).

I'd like to echo the opinions of others who've commented on your gas problems. It is most likely the Truvada component of your regimen that is to blame. My friend recently started Truvada/Sustiva and is experiencing many of the bloating problems you mention.

Offline Miss Philicia

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  • celebrity poster, faker & poser
Re: I want to drop Norivir from my Truvada combo
« Reply #6 on: September 21, 2009, 02:03:22 PM »
another company is looking into producing a booster that has none of the gastro-intestinal problems of Norvir (and none of the anti-HIV activity either).

GS-9350, and just today this appeared in relation to it working with Reyataz

http://www.aidsmap.com/en/news/B470830A-3221-4614-9FC7-49AC0D27E4E9.asp
"Iíve slept with enough men to know that Iím not gay"

Offline antibody

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  • Posts: 525
  • "every man thinks his burden is the heaviest"
Re: I want to drop Norivir from my Truvada combo
« Reply #7 on: September 21, 2009, 07:06:35 PM »
I am talking to my Doctor about dropping the Norvir and going up tp 400mg on the Reyataz. There was a recent study where this is possible if you have remained undetectable for at least a year.
http://www.aidsmeds.com/articles/hiv_reyataz_atazanavir_1667_16988.shtml
I would prefer this route than to try some new booster just because they made one. I want to take less medications in the long run.
« Last Edit: September 21, 2009, 07:23:03 PM by antibody »
Timbuk      <50/ 794  CD4 10/06 
                 <50/ 1096 CD4 3/07
                 <40/ 1854 CD4 4/09

Started Atripla  7/14/06
Switched to boosted Reyataz Truvada 3/28/07

*Ask me about Medical Marijuana and how it can help you!*

Offline BM

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  • Posts: 340
Re: I want to drop Norivir from my Truvada combo
« Reply #8 on: September 22, 2009, 07:09:03 PM »
But it's not recommended to drop Norvir at all if your combination also contains Truvada (tenofovir/emtricitabine) or Viread (tenofovir). This is because tenofovir causes blood levels of (unboosted) Reyataz to fall dramatically, even at the 400mg dose. The Norvir stops this from happening.

Offline Robert

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  • Posts: 2,644
Re: I want to drop Norivir from my Truvada combo
« Reply #9 on: September 22, 2009, 08:28:25 PM »

hi blowncircuit.

I also had been having issues with Norvir and talked it over with my Dr at my last check-up in July.  Since Dec, 2003 I've been taking Truvada, Reyetaz, Norvir.  Together we dropped the Norvir and the Truvada, increased the Reyataz from 300mg to 400mg (2 200 mg tablets) and added Epzicom (Epzicom must be combined with at least one other HIV drug, usually a protease inhibitor (PI) (the Reyataz) or a non-nucleoside reverse transcriptase inhibitor (NNRTI) and is a combination of Abacavir and Lamivudine.)


It's still too early to report about the numbers but I am happy to say the bloatedness and the gas have all but disappeared.  I might also add my constipation has gone by the wayside too.  I've always suspected it was from the Norvir and apparently it's so.

Norvir is one of the two drugs in Kaletra. I despise Kaletra and, as far as I'm concerned, that's reason enough to drop the Norvir.

Like I said, it's too early to tell but talk it over with your Dr.  Even though your combo is working (my numbers were very similar to yours) if you don't like, do something about it.

robert
..........

Offline antibody

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  • Posts: 525
  • "every man thinks his burden is the heaviest"
Re: I want to drop Norivir from my Truvada combo
« Reply #10 on: September 22, 2009, 11:47:04 PM »
It is possible I might switch out the Truvada for Epzicom so I could drop the Norvir.
Timbuk      <50/ 794  CD4 10/06 
                 <50/ 1096 CD4 3/07
                 <40/ 1854 CD4 4/09

Started Atripla  7/14/06
Switched to boosted Reyataz Truvada 3/28/07

*Ask me about Medical Marijuana and how it can help you!*

Offline J.R.E.

  • Member
  • Posts: 7,120
  • Joined Dec-2003 Living positive, since 1985.
Re: I want to drop Norivir from my Truvada combo
« Reply #11 on: September 23, 2009, 08:17:19 AM »
Gilead is working on a new PK booster , that shows promise ;

http://www.poz.com/articles/hiv_gs9350_norvir_761_17294.shtml

But, I am also on Viread, and have the issues with gas. I am not on Norvir.

Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 6/4/14,  t-cells are at 423, Viral load <40

 Current % is at 13% 

  
 62 years young.

Offline risred1

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  • My Source for Supps - www.newyorkbuyersclub.org
Re: I want to drop Norivir from my Truvada combo
« Reply #12 on: September 23, 2009, 10:38:31 AM »
Robert,

I'm a little confused. Switching Truvada to Epzicom and doing 400 mg of Reyataz is within guidelines. But not with Truvada, which lowers Reyataz in the blood. Are you swapping out Truvada for the Epzicom?

Antibody,

In light of your herbal use...

I would be concerned that loosing the boosting properties of norvir may make you more vulnerable to the possible effects of marijuana on Reyataz... I know, to early to know for sure.

just putting in a couple of cents.

risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

Offline Robert

  • Member
  • Posts: 2,644
Re: I want to drop Norivir from my Truvada combo
« Reply #13 on: September 23, 2009, 12:19:13 PM »

hi risred.

I have dropped both the Truvada and the Norvir.  Now I am taking Reyataz (400mg) and the Epzicom only. 

Well, I also take 150mg of Effexor/day (for depression), Levothriod (.2mg)/day (for thyroid) and an iron pill. 

I'll update my numbers in Nov. after my next visit to the Docs.

robert
..........

Offline blowncircuit

  • Member
  • Posts: 6
Re: I want to drop Norivir from my Truvada combo
« Reply #14 on: September 27, 2009, 02:44:16 PM »
Thanks to everyone for their responses. I did not consider it might be the Truvada that is giving me the gas/bloat issues. Good to know.
I'm also glad to know the Norivir is not as fragile as I make it out to be.  ;D

Offline weasel

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Re: I want to drop Norivir from my Truvada combo
« Reply #15 on: September 27, 2009, 08:48:02 PM »
I find it odd  ?

 I have been on these same drugs for 5 years .

 No bloating , no gas  ????

NO yellow ??

It MAY  be what you guys are eating !

                                       just my thought  :o

                                                          Carl
" Live and let Live "

Offline BM

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  • Posts: 340
Re: I want to drop Norivir from my Truvada combo
« Reply #16 on: September 28, 2009, 12:46:04 PM »
I find it odd  ?

 I have been on these same drugs for 5 years .

 No bloating , no gas  ????

NO yellow ??

It MAY  be what you guys are eating !

                                       just my thought  :o

                                                          Carl

Or you're just one of the lucky ones who doesn't get these symptoms!

Offline jay195

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  • Posts: 67
Re: I want to drop Norivir from my Truvada combo
« Reply #17 on: September 28, 2009, 03:47:16 PM »
Hi to everyone. I have been  on the Truvada, Reyataz , Norvir combo for about nine months with no problems at all. Why does Norvir have to be kept in the fridge ?       Jay xx                                                 

Offline antibody

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  • Posts: 525
  • "every man thinks his burden is the heaviest"
Re: I want to drop Norivir from my Truvada combo
« Reply #18 on: September 28, 2009, 08:16:41 PM »
Yea I've had no gas, bloating, yellowing, diarrhea or any side effects for that matter other than constant fatigue (no idea if it's related to combo). My reason to drop the Norvir is for less pill count and to avoid any harm from long term use but I must say that this combo has been a breeze. I have had zero problems with this combo and have always been undetectable so I'm sure my reasons to want to drop Norvir is not the same as your reason.
Timbuk      <50/ 794  CD4 10/06 
                 <50/ 1096 CD4 3/07
                 <40/ 1854 CD4 4/09

Started Atripla  7/14/06
Switched to boosted Reyataz Truvada 3/28/07

*Ask me about Medical Marijuana and how it can help you!*

Offline NYCguy

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  • Posts: 180
Re: I want to drop Norivir from my Truvada combo
« Reply #19 on: October 15, 2009, 05:32:01 PM »
just my 2 cents.. I've been on Reyataz/Truvada/Norvir for 2.5 years, been undetectable from the beginning and have had absolutely no problems other than a bit of the runs when I first started, or whenever I don't eat enough.  My philosophy is if it ain't broke... but I've never experienced the bloating problem.  I'm assuming that you are eating a respectable meal, because this combo must be taken with food to be effective.  I always take mine in the morning, in case that makes a difference?  Hell, on weekends I sometimes swish them down with a bloody Mary! 

The norvir I try to keep in the fridge, but don't worry about it so much, especially when traveling, and it seems to be fine.  Looking forward to the new formulation.

I would be very careful about dropping norvir from the combo if staying on Truvada.  If you do this, make SURE it is with a doctor who really knows his stuff and has a lot of experience with other patients on the same combo.  I personally don't know anyone doing this and tons are taking the boosted combo with success.  So be careful.



11/9/06 = #$%^&!
sometime early Dec 2006:
CD4 530 20%/VL >250,000 (&*$$%!!)
started Reyataz300mg/Norvir/Truvada 12-27-06.
1/30/07 CD4 540 30%/VL <400
4/07 CD4 600+ 33%/VL <50
6/9/07 CD4 720 37%/VL <50
10/15/07 CD4 891 (!) %? VL <50
1/2010 CD4 599 (37%) VL<50 (drop due to acute HCV)
9/2010 - looks like HCV is gone for good! And I'm finally drinking again, thank GOD
2013 - considering a switch to Stribild. but I love my Kidneys (but I hate farting all the time!)...
June 2013 - switched to Stribild.  so far so good...

Offline NYCguy

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  • Posts: 180
Re: I want to drop Norivir from my Truvada combo
« Reply #20 on: October 15, 2009, 05:33:09 PM »
also remember that 100mg of Norvir is a very low dose...the doses that caused all the problems in the 90s were, I believe, in the area of 8-10 times higher.
11/9/06 = #$%^&!
sometime early Dec 2006:
CD4 530 20%/VL >250,000 (&*$$%!!)
started Reyataz300mg/Norvir/Truvada 12-27-06.
1/30/07 CD4 540 30%/VL <400
4/07 CD4 600+ 33%/VL <50
6/9/07 CD4 720 37%/VL <50
10/15/07 CD4 891 (!) %? VL <50
1/2010 CD4 599 (37%) VL<50 (drop due to acute HCV)
9/2010 - looks like HCV is gone for good! And I'm finally drinking again, thank GOD
2013 - considering a switch to Stribild. but I love my Kidneys (but I hate farting all the time!)...
June 2013 - switched to Stribild.  so far so good...

Offline frankt

  • Member
  • Posts: 22
Re: I want to drop Norivir from my Truvada combo
« Reply #21 on: October 19, 2009, 08:02:33 AM »
the problem is most likely reyataz. the moment i cut out reyatax most of my internal problems subsided.prezista is a miracle drug

 


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